Stepping off the 'hamster wheel': How payers have stepped in to support burnt out workforces

Burnout in the healthcare workforce isn't going away, but some payers are finding ways to help. 

A recent Medscape report found 53 percent of physicians report feeling burnout, and 23 percent reported experiencing depression. 

As challenges persist, some payers are supporting the provider workforce through investments and simplifying the administrative workloads many providers face. 

Investing in workforces 

In December, the UnitedHealth Foundation said it would put $3.1 million into an initiative to support nurses experiencing burnout. 

Mary Jo Jerde, BSN, RN, senior vice president and leader of the center for clinician advancement at UnitedHealth Group, said the pilot program is aimed at tackling the systemic causes of burnout. 

Ms. Jerde told Becker's the initiative is a "stress first aid program." 

"It was really designed to think about the needs of an organization, and how you transform that culture," Ms. Jerde said. "Many times there's a stigma around asking for help, for the mental health support you might need." 

The pilot, a collaboration with the American Nurses Foundation, is starting in four health systems and will later expand to include over 50,000 nurses. 

The program uses peer support, Ms. Jerde said, using a "train the trainer" model. 

"They are identifying a champion in these facilities, health systems. The champions will be trained, then they will come back and train others within their teams," Ms. Jerde said. "You start at the top, with this designated champion, and they come back to the organization and say, 'Okay, now let's go deep.'" 

In another workforce investment program, L.A. Care, the nation's largest publicly operated health plan, has put $26 million into student debt repayment for Los Angeles County physicians over five years, part of the organization's larger $155 million "Elevating the Safety Net" initiative. 

John Baackes, CEO of L.A. Care, told Becker's the program is intended to address physician shortages in underserved communities. 

"We think our mission as a health plan is to look at the whole person, and we have to look at our network of providers to be taken care of," Mr. Baackes said. 

The program has supported loan repayments for 126 physicians in primary care practice in Los Angeles county. 

"This program has allowed them to follow their mission and why they got into medicine," Mr. Baackes said. "Medical school generally drives many doctors who might otherwise have gone into primary care to go into specialities, so they can make enough money to pay back their debts." 

Simplifying paperwork 

Another significant cause of provider burnout? Paperwork. Reducing the burden of prior authorization and other paperwork requests is one of the ways U.S. Surgeon General Vivek Murthy, MD, says payers can ease healthcare worker burnout. 

Mr. Baackes said to reduce administrative burdens, L.A. Care has to be an advocate for providers in its network.

"The regulations require it. What we're saying back to the regulators is simplify simplify simplify. 'What are you doing with that data? Do you really need all that data?' That's what we're trying to challenge," he said. 

Alex Ding, MD, associate vice president of physician strategy and medical affairs at Humana, told Becker's there are a number of ways to approach mitigating burnout, some of which insurers can play a role in, including automating practices like prior authorization. 

"As a practicing physician, as someone who does operations and procedures, it takes me twice as long to do all the paperwork and administrative tasks as it does to actually perform the operation," Dr. Ding said. 

Beyond paperwork, alternative payment models offer another path for improving morale. Value-based care can help ease burnout by providing practices with more financial stability and increasing patient satisfaction, Dr. Ding said. 

"We hear stories from doctors saying that in value-based care, they're able to step off the proverbial hamster wheel and spend more time with their patients, that they are able to invest in a more robust clinical care team that really provides a lot more support," he said. 

Payers also have to address burnout in their own organizations, as some of the largest employers of physicians and other clinicians. Humana employs well over 10,000 clinicians, Dr. Ding said. UnitedHealth Group is the largest employer of physicians in the U.S., with a workforce at least 60,000 strong. 

Employers of clinicians need to be focused on recruitment and retention for the future, Dr. Ding said. 

"They're going to have to create cultures that are not only clinician informed, but clinician driven as well. Building growth and development opportunities, and to really create a welcoming environment where clinicians feel like they belong as part of the larger workforce," he said. 

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